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SELECTED ARTICLES FROM THE RECENT LITERATURE 2006
10/4/06
Increasing the use of pneumococcal immunization
Summary
Background - Invasive pneumococcal infection (IPI) causes major morbidity and mortality. IPI can be usually prevented in patients by prior immunization with the pneumococcal polysaccharide vaccine (PPV). But is such prevention being carried out effectively?
Findings - Greene et al of the CDC in Atlanta examined the frequency of IPI in several populations followed in their network. They found that only 38% of individuals in whom PPV was currently indicated (age > 64 years, contain chronic medical conditions) had actually received the PPV. If all had received the PPV, 21% of the cases of IPI could have been prevented. By lowering the age indication for PPV immunization to age 50 years an addition al 5-7% of IPI cases could have been prevented. Less frequent prevention would result if PPV were given to all smokers, African-Americans, and asthmatics.
Reference
Clin Infect Dis 2006;43:141-50
Editor's Comments
It is puzzling why only 38% of those for whom PPV is currently indicated actually receive this vaccine since such immunization is currently recommended as a "one-time" event. Also, I would have expected chronic asthma to be a stronger indication for PPV immunization in face of evidence that asthmatics are at increased risk for IPI (N Engl J Med. 2005;352:2082-90).
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